Individual
AUDREY JANE FISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
374 MERIDIAN PARKE LN, GREENWOOD, IN 46142-9406
(317) 899-5437
Mailing address
374 MERIDIAN PARKE LN, GREENWOOD, IN 46142-9406
(317) 899-5437
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-140743
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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